ASK THE EXPERTS

LYNN HALLARMAN, MD.

Lynn Hallarman, MD, one of the first physicians in the country to be board certified in palliative medicine, talks about what palliative care is and why it is a priority at Stony Brook University Medical Center.

Palliative care is patient and family centered care that optimizes quality of life by anticipating, preventing, and treating suffering. The goal is to provide support to patients undergoing treatment for life-limiting illness such as cancer, congestive heart failure, chronic obstructive pulmonary disease (COPD), heart disease, devastating stroke, or dementia. Support can be physical, emotional, or spiritual. It may involve practical measures, and often involves helping families deal with stress or difficult decisions. Palliative care is not prognosis dependent and can be provided at the same time as life-prolonging treatment such as chemotherapy.

How is it different from hospice care?
It is important to note that hospice may be just one component of the full spectrum of palliative care. Hospice deals with the last three to six months of a patient's life. Hospice is a structured program of care once disease directed treatments are losing their benefit. Care can be provided in many settings, including nursing homes, inpatient facilities, and "hospice house" locations. Hospice also helps families take care of their loved ones at home.

How is palliative medicine delivered at Stony Brook?
At Stony Brook University Medical Center, specialized palliative care services are available by consultation with the Survivorship and Supportive Care (SOS) Team. Our team consists of two nurse practitioners, one physician, one social worker, and one pastoral care counselor. An example of SOS services is the care provided to a young, college-age woman studying to be a doctor who had metastatic melanoma. Care was provided over the course of a year and through several hospitalizations. The Survivorship and Supportive Care Team worked with the patient's oncologists to alleviate the pain and fatigue she was experiencing. In addition, the patient, a single mom, needed help with child care and custody issues, which we helped her sort out. Later, when she needed surgery, we supported her and her family through her hospitalization.

Another example involves a patient with advanced emphysema who could no longer live at home. We collaborated with the primary care team to find the appropriate care setting, assisted with a symptom management plan, facilitated communication with the family, and helped the patient designate a healthcare proxy. Both examples point to the multidisciplinary nature of our work. We are connected to a vast network of community resources and to the different treatment teams in the Hospital, so we can offer a full spectrum of assistance no matter what the patient's needs are.

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